Organization Active NPI

Jerome R Caiati MD.,PC.

  • Internal Medicine Physician
  • Rockville Centre, NY
National Provider Identifier
1336406727
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
143823 Issued in NY
Legal business name
JEROME R CAIATI MD.,PC.
Practice address
165 N Village Ave
Suite#134
Rockville Centre, NY 11570
Phone
(516) 764-6605
Fax
(516) 764-6243
NPI assigned
Apr 23, 2012
Last updated
Apr 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jerome Robert Caiati, MDNPI 1932269289
Title
Doctor
Phone
(516) 764-6605

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 143823 NY Primary

Addresses

Primary practice location

165 N Village Ave
Suite#134
Rockville Centre, NY 11570

Mailing address

165 N. Village Ave
Suite134
Rockville Centre, NY 11570
Phone (516) 764-6605

Other identifiers 1

IdentifierTypeStateIssuer
02023307MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120515000136 NY Part B Supplier - Clinic/Group Practice 0244493054 Receives reassigned benefits from 1 practitioner
Practice locations: Rockville Centre, NY

National Provider Directory

National Provider Directory

Locations

165 N Village Ave
Ste 134
Rockville Ctr, NY 11570
Phone (516) 764-6605

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335139200000",
    "number": "1336406727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 N. VILLAGE AVE",
            "address_2": "SUITE134",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "11570",
            "telephone_number": "516-764-6605",
            "fax_number": "516-764-6243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 N VILLAGE AVE",
            "address_2": "SUITE#134",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "11570",
            "telephone_number": "516-764-6605",
            "fax_number": "516-764-6243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEROME R CAIATI MD.,PC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-23",
        "last_updated": "2012-04-23",
        "status": "A",
        "authorized_official_last_name": "CAIATI",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "516-764-6605",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "143823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02023307",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.